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An Overview of COVID-19 Treatment
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Saffora Riaz, Farkhanda Manzoor, Dou Deqiang, Najmur Rahman
Avigan (favipiravir) is affirmed in Japan and China against influenza is an antiviral medicine that has shown preventive impact on SARS-CoV-2 contaminated human cells. Flu infection may be just the trouble, so favipiravir is safe in case of flu infection. For reappearing flu infections, favipiravir was affirmed in China and Japan in 2014. Favipiravir used to treat flu infection by joining RNA of the virus and stimulated the mutagenesis by acting as a mutagen. No legislative approval about Favipiravir use against coronavirus is reported [52–55].
Drug Repurposing and Novel Antiviral Drugs for COVID-19 Management
Published in Debmalya Barh, Kenneth Lundstrom, COVID-19, 2022
Shailendra Dwivedi, Aakanksha Rawat, Amit Ranjan, Ruchika Agrawal, Radhieka Misra, Sunil Kumar Gupta, Surekha Kishore, Sanjeev Misra
Favipiravir (Avigan; Appili Therapeutics) is an oral antiviral drug approved for the treatment of influenza in Japan. It is approved in Russia for treatment of COVID-19. Favipiravir selectively inhibits RNA polymerase, which is necessary for viral replication. An adaptive, multi-center, open label, randomized, phase II/III clinical trial on favipiravir compared with standard of care in hospitalized patients with moderate COVID-19 was conducted in Russia. Both dosing regimens of favipiravir demonstrated similar virologic responses. Viral clearance on day 5 was achieved in 25/40 (62.5%) patients in the favipiravir group compared with 6/20 (30%) patients in the standard care group (P = 0.018). Viral clearance on day 10 was achieved in 37/40(92.5%) patients treated with favipiravir compared with 16/20 (80%) in the standard care group (P = 0.155) [12].
Conventional Pharmacological Strategies, Investigational Drugs, and Immunotherapies for COVID–19
Published in Srijan Goswami, Chiranjeeb Dey, COVID-19 and SARS-CoV-2, 2022
Subhra Bhattacharya, Srijan Goswami, Chiranjeeb Dey
Developed by Toyama Chemical in 2014 (Japan), favipiravir, the experimental antiviral drug is an RdRp inhibitor. It acts as a molecular mimic by structurally resembling guanine. It was originally developed to deal with diseases like influenza A, influenza B, Ebola, and norovirus infection. Favipiravir (the guanine analog) is known to disrupt viral RNA synthesis by competitively binding in the place of natural guanine, thus disrupting the structure and rendering RdRp ineffective (see Figure 9.4). Clinical trials revealed that the positive effect of favipiravir on critically ill COVID-19 patients was not significant but a range of adverse reactions like gastrointestinal complications (diarrhea, nausea, vomiting, abdominal pain, duodenal ulcer, hematochezia, gastritis), hyperuricemia, increased level of transaminases, decrease in neutrophil count, teratogenic effect and embryotoxicity, hypersensitivity reactions (rashes, eczema, pruritus), hepatic complications (increased AST, increased ALT, increased γ-GTP, hyperbilirubinemia), respiratory complications (asthma, inflammatory condition of upper respiratory tract), metabolic complications (hypokalemia, increased blood triglyceride levels), and disturbed neurological coordination have been documented in relation to the treatment of COVID-19 patients. Favipiravir is still under clinical trial (Lam et al., 2020; Furuta, 2017; McKee et al., 2020).
Myocarditis: causes, mechanisms, and evolving therapies
Published in Expert Opinion on Therapeutic Targets, 2023
Tin Kyaw, Grant Drummond, Alex Bobik, Karlheinz Peter
RNA polymerase inhibitors: RNA-dependent RNA polymerase (RdRp) is the central component of coronaviral replication and transcriptional machinery and a prime target for therapeutic intervention [136]. Nucleoside analog inhibitors acting at the substrate site have been developed whilst other non-nucleoside inhibitors acting at allosteric binding sites are in development [137]. Molnupiravir is used to treat SARS-CoV-2 infections, whilst others such as favipiravir are still in clinical trials or in development and can, in addition to inhibiting SARS-CoV-2 replication, also exhibit antiviral activity against other RNA viruses including enteroviruses [138]. Favipiravir also exhibits antiviral activity against the myocarditis-causing coxsackievirus B3 virus in vitro but it efficacy in vivo still requires further studies [139]; it is still unclear whether Favipiravir will be useful in preventing coxsackievirus B3-induced myocarditis and more potent, specific inhibitors will likely be required. Favipiravir was initially designed to inhibit influenza infections. Non-nucleoside inhibitors are in the early stages of development and change the conformation of RdRp by binding to allosteric sites on the surface of the polymerase, thus affecting the binding of substrates to the catalytically active site; suramin is one such inhibitors [140]. Their efficacy in preventing SARS-CoV-2 and coxsackievirus-6B myocarditis is yet to be elucidated.
The course of COVID-19 in patients with severe asthma receiving biological treatment
Published in Journal of Asthma, 2022
Gülseren Tuncay,, Mehmet Erdem Cakmak,, Ozge Can Bostan,, Saltuk Bugra Kaya,, Ebru Damadoglu,, Gül Karakaya,, Ali Fuat Kalyoncu,
The interruption information of those who have and have not had COVID-19 are detailed in Figure 1. Asthma control was significantly better in 63 (84%) patients who had continued regular injections compared to 12 (16%) patients who had interrupted (p = 0.006). Of the 14 (19%) patients diagnosed with SARS-CoV-2 infection, 6 (43%) continued regular injections, and 8 (57%) patients interrupted their biological treatment. The risk of having COVID-19 was detected to be higher in the group that interrupted treatment (Relative risk:2.71; 95% Confidence interval:1.21–6.06). The most common thorax CT finding in patients with COVID-19 pneumonia was peripherally located ground glass density. COVID-19 pneumonia had been diagnosed in 9 (64%) patients and of these, 4 patients were hospitalized, and 2 were followed up in the ICU because of respiratory failure. While favipiravir was recommended to all those who received treatment, two patients refused to take it. Enoxaparin was given as anticoagulant treatment to four inpatients. The characteristics of patients diagnosed with COVID-19 are shown in Table 2.
Pharmacological interventions for COVID-19: a systematic review of observational studies and clinical trials
Published in Expert Review of Anti-infective Therapy, 2021
Nida Bokharee, Yusra Habib Khan, Aisha Khokhar, Tauqeer Hussain Mallhi, Nasser Hadal Alotaibi, Maria Rasheed
Favipiravir, a broad spectrum antiviral drug, was initially approved for the use against influenza. The plausible mechanism of action against SARS-CoV-2 is its ability to interfere with viral replication. It incorporates into ribonucleic acid (RNA) of the virus, hence, potentially inhibiting the RNA dependent RNA polymerase (RdRp). These inhibitory effects of favipiravir have been shown against wide range of viruses, including Ebola virus [107,108]. Since genome sequence is similar to SARS-CoV-2, favipiravir carries potential benefits to treat COVID-19 [15,109,110]. In a trial conducted by Cai et al., 2020, favipiravir showed significant and better results than LPV/RTV [15]. In one study, favipiravir concentrations in critically ill patients were much lower than that in healthy volunteers, which is of great concern during the treatment [111]. Further studies are required to ascertain the optimal strategy for treatment of patients with severe COVID‐19 Favipiravir is the emergent potential treatment option with promising results from completed trial with higher improvement rate. However, it is difficult to draw firm conclusion on available data and more studies are required to elucidate the beneficial impact of these regimens for COVID-19 patients.